Comparative Effectiveness

2006

The American Heart Association (AHA) used AHRQ's Evidence Report/Technology Assessment No. 80, Results of Systematic Review of Research on Diagnosis and Treatment of Coronary Heart Disease in Women, to help inform the recent update of AHA's Scientific Statement, Evidence-based Guidelines for the Prevention of Cardiovascular Disease in Women. The evidence report had a direct and substantial impact in formulating recommendations for improving the prevention of women's heart disease in primary care settings and increasing research on cardiovascular disease in women.

"Not only was AHRQ's [evidence] report the first systematic review focusing specifically on testing, prevention, and treatment of coronary disease for women, but it also led to the development of the first rigorously reviewed prevention guideline regarding cardiovascular disease in women," notes Rose Marie Robertson, MD, Chief Medical Officer at the AHA. "The material in the [evidence] report that dealt with aspects of preventing cardiovascular disease served as a significant impetus for us to write a prevention guideline."

In developing the guideline, findings from the evidence report were brought to a specially impaneled AHA committee and were part of the discussions in which the committee agreed on its final recommendations. As Robertson explains, "The group was aware of AHRQ's evidence report, and it was important in that it provided background information and informed the overall thinking of the group."

The evidence report contributed positively to increasing public awareness of the issue of cardiovascular disease in women as well. "The report really awakened many in the cardiovascular community to a number of issues, such as the disparity of care and differences in outcomes by gender, and led to a new focus on these questions in terms of subsequent studies and meta-analyses that highlighted cardiovascular disease in women as an important public health issue," Robertson explains.

Findings from the evidence report further contributed to a renewed policy emphasis to include more women in studies and for researchers to analyze and report study findings by gender. Prior to the release of the evidence report, the vast body of guidelines on prevention and treatment coronary heart disease was based primarily on studies that either excluded women entirely or included only limited numbers of women.

As Robertson explains, "The [evidence] report added momentum to a growing movement either to request-or, so far as one can, demand-that data be provided and made available by gender. Even though some studies included a substantial number of women, the data were not readily available in a gender-specific format. Most often, the data were reported in terms of the general population."

Results of Systematic Review of Research on Diagnosis and Treatment of Coronary Heart Disease in Women. Summary, Evidence Report/Technology Assessment Number 80. May 2003. AHRQ Publication No. 03-E034. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/epcsums/chdwomsum.htm